I'm a clinical psychologist specialising in evidence-based psychotherapies for anxiety, depression, and trauma in teens and adults at Pacific Anxiety Group in Menlo Park, CA. While starting therapy comes with its own set of uncertainties, knowing when to stop your regular appointments can be just as confusing. By the time you've reached the end of a successful course of psychotherapy, you and your therapist may have developed a strong bond, so it's helpful to have a good sense of what to look for ahead of time. Here are seven signs it might be time to consider ending therapy.
1. You Have an Increased Sense of Wellbeing
You feel less encumbered by smaller things that would have been "day ruiners" before therapy started. Most people also notice a drop in physical tension, reactivity, and irritability, and an improvement in their sleep.
2. You're Making the Bold Moves You've Always Wanted to Make
For someone with social anxiety, this could mean finally speaking up in a meeting when they have a great idea. For others, it might be pursuing schooling or a career path they're passionate about and have the resources to pursue, but always thought they weren't "good enough" to succeed in. It's value-driven behaviour that flies in the face of what we once thought was possible for us in this life.
3. You Recognise Unhealthy Patterns
You've gained insight into the common psychological processes you experience. This means if you worry a lot, you can recognise the worrying for what it is: an uninvited guest that you don't need to be in an adversarial relationship with. (In my practice, we sometimes even name the worry or rumination: "Here comes Janet again with that same old stormy weather report.") You may also notice that you're saying what you actually mean: for example, you'll acknowledge that you're simply annoyed instead of furious, if your frustration hasn't reached that magnitude.
4. You Can Extend Yourself Compassion
One major tenant of acceptance and commitment therapy, one of the therapies I practice, is that you are whole as you are, right here, right now. So much possibility can open up when someone comes into contact with this truth, and it's exciting to witness. I can hear it in how a person talks about what is happening in their life; the narration is gentler.
5. You Sometimes Use Skills Without Thinking
From a therapy perspective, being skillful is kind of like dancing; get enough practice in and after a while, it comes more easily. This can look like someone with severe depression realising that they've gotten out of bed without much difficulty, or someone who struggles with communicating directly being assertive without needing to review the acronym they learned during dialectical behaviour therapy.
6. You've Largely Met Your Goals
In the first session, I ask my clients, "If this therapy went as well as it could possibly go, what would you be doing differently?" The whole treatment plan flows from this. The answer to that one question is an ongoing conversation that starts at the beginning of psychotherapy. Don't feel pressure to hold onto a therapist just because you like them. Most forms of evidence-based psychotherapy were designed to be short-term, and if your situation changes, you can always reach out again.
7. You and Your Therapist Decide It's Time
Sometimes there are symptoms that never going to be addressed, often at the request of the patient. For example, a patient might tell me that they want treatment for their obsessive-compulsive disorder, but they don't want to work through their trauma. In that case, I would explain what treatment would look like if we pursue that path, and ask them to let me know if their decision changes. This is therapy, not dentistry. It's a collaboration that requires both parties to agree on a set of goals and respect what's possible at any given time. If you feel you've gotten as far as you can, it's probably time to step away.